Community clinic health care through the WASH Project

In the spirit of the well-known slogan "Sheikh Hasinar Abadan, Community Clinic Bachai Pran" (Sheikh Hasina's contribution, community clinics save lives)", community clinics have been delivering primary health care services in rural Bangladesh since 2000. Currently, these clinics have distributed 27 medicines free of cost alongside providing family planning, immunization, nutrition, child care, pregnancy and post-delivery care. Each clinic designed to serves a population of approximately 6,000 people, though currently it is serving more than estimated population.

The 35 community clinics located in Gangni upazila in Meherpur district serve almost three lakhs of people. These clinics usually consist of just two rooms and are built on small plots of land. Over time, structural weaknesses, lack of maintenance and inadequate water supply and sanitation had become major barriers in the provision of care. The lack of safe drinking water, proper toilets and handwashing facilities posed challenges for clients, particularly for pregnant women, elderly patients and people with disabilities. However, this disheartening scenario is now changing, with the Union Parishad-led "LGI-led WASH in Health" project transforming 29 out of these 35 clinics, technical and financial supported by non-governmental organizations (NGOs) WaterAid and SKS Foundation.

Under this project, several improvements have been made in the 29 clinics, including ensuring safe water supply, accessible toilets with running water, handwashing points for staff and patients and ramps for people with accessibility issues. A waiting area has been built for patients travelling from long distances. The Upazila Parishad has also provided a wheelchair for patients who might need the extra support during their visits.

Alongside, the project has contributed to improving management and building the capacity of stakeholders associated with these clinics. Staff has received training on the link between health, nutrition and water, sanitation and hygiene (WASH). The Community Groups and Community Support Groups that support the management of community clinics have also been trained on their roles and responsibilities. The health department has enhanced its monitoring and supervision of the facilities, ensuring better upkeep.

The impact of these interventions is reflected in the increased uptake of clinic services and increased satisfaction of clients. The Community Health Care Provider (CHCP) of Sholotaka Community Clinic said, "Last year, the number of clients was 6,879. Following the project's interventions, this has risen to 8,306 people." However, he also noted that because the supply of medicines was not adequate to serve the actual increased number of patients, it was not possible to register all clients.

Shaban Khatun, a resident of Sanghat village, appreciates the changes in the nearby clinic - "The environment of my clinic has improved so much, especially when you look at the state of water and sanitation, and the seating arrangements made. But the clinic runs out of medicine by the middle of the month. My request to the government is to please increase the supply of medicines, then poor people like me can live".

The Chairman of Kathuli Union Parishad, Mizanur Rahman Rana, said, "The repairs to the community clinic and the improvements to their WASH infrastructure are a response to the demands of the people of Gangni, and will contribute to the achievement of SDG 6. I believe that if we had access to technical and financial support, we could create many more such inspiring examples."

The Project Coordinator from SKS Foundation, Mizanur Rahman Akhand, mentioned that, "A separate fund has been created with the support of the Community Group to ensure maintenance of WASH facilities and overall management." He also expressed the need for proper implementation of national policies and guidelines, oversight from the Union Parishad, and adequate funding, to ensure sustainable development.